orthopaedic

  1. R

    Question 29823, 29827 Clarification 2021

    Hello! I am reaching out to ask some questions regarding 29823. In an effort to explain to my providers the use of 29823, I want to make sure my understanding is accurate. 29823 (Arthroscopy, shoulder, surgical; debridement, extensive 3 or more discrete structures (eg, humeral bone, humeral...
  2. K

    Shoulder- Removal of failed hemi - to a total shoulder

    I am not sure which way to code this one. The patient had a hemi arthroplasty and it failed so they decided to remove the hemi and do a total shoulder. There are no conversion codes and even if there were I don't know if it would apply here because the humeral was a revision and the glenoid was...
  3. R

    Question BILATERAL X-RAY

    AZ Complete Health (Medicaid) recouped multiple claims we have billed as follows: 99203 (M17.12) - PAID 73562-LT (M25.562) - RECOUPED/DENIED 73562-RT(M25.561) - RECOUPED/DENIED We also have other claims that we billed different x-ray codes for bilateral areas with -LT and -RT that have...
  4. K

    External Neurolysis

    I need advice as I have never coded an external neurolysis. I know internal would be the primary cpt plus 64727, but would this be 64708? PREOPERATIVE DIAGNOSIS: Laceration to the left index finger dorsal aspect in the MP joint area. POSTOPERATIVE DIAGNOSIS: Laceration to the left index finger...
  5. K

    Excision dupuytren's nodule & trigger finger release

    My doc wants me to bill for the trigger finger portion and the nodule excision, but I feel like the nodule was incidental? Am I incorrect? Preoperative diagnosis: Right long trigger finger Dupuytren's nodule Postoperative diagnosis: Right long trigger finger Dupuytren's nodule Operation...
  6. K

    Excision of mass left small finger, left carpal tunnel release

    How would you code this? I am reading mucoid degeneration and he keeps extending the incision, but I don't think an actual cyst was removed. The carpal tunnel was not planned, can I bill it with the cyst excision 26160 or should I bill the arthrotomy with exploration 26070-26080? Preoperative...
  7. K

    Question Finger Capsulotomy/ Tenolysis

    I don't like hand coding and would love any webinar recommendations, or just general reading information to help me dive deeper. This doc tends to lack details/ dictation but when queried he doesn't respond or will say don't bill it. With this surgery I just don't think there is enough details...
  8. K

    Question Dupuytren partial palmar release left small & possibly left ring

    Here is my question I know I can code 26123-F5 but through out the op note he is also dissecting the left ring finger which he also says is involved but he did not state the left ring finger in the operation performed/ postop diagnosis. Can I bill 26123-F5 and 26125-F4 or just 26123...
  9. K

    Repair extensor pollicis longus left hand

    I was just wondering if I can only code the repair 26418 or if I can also code the exploration. POSTOPERATIVE DIAGNOSIS(ES): Extensor pollicis laceration left hand PROCEDURE: Surgical exploration of the wound, repair of the extensor pollicis longus left hand INDICATIONS: Patient suffered a...
  10. D

    Question Pilon vs Trimalleolar Fx

    Good morning! I need some help in deciding if this is a Pilon Fx-27828- and ankle dislocation with IF-27848- (per what the doctor is requesting) or if this should be coded as a trimalleolar ORIF. I've gone back and forth with this any help or advice will be appreciate....below is the OP note...
  11. N

    In Urgent Care setting, Can a Physcian Assistant bill a new pt using his/her own NPI?

    Hi coder family:) I guess my question is can P.A's see new patients in Urgent Care? I am auditing our P.A.'s who see patients Monday-Sunday in Ortho Urgent Care. My question is, if a new patient comes in to be seen and a P.A. see's them for the first time. Would the P.A. be able to bill...
  12. B

    Ortho to Hosp Admit

    B][/B]I need some help with an e/m situation. I have a doctor here in our Ortho practice that saw a patient on one day (lets say Monday) and admitted her that day to the hospital. He is also the operating surgeon and saw the patient the next day (lets say Tuesday) in the hospital and then...
  13. T

    Sequela fx with pain

    Can someone answer this for me? Patient comes in 18 months after pilon fx (healed). Patient now has pain in that ankle with no OA. Should I code: M25.572 and Z87.81 or M25.572 and S82.872S
  14. T

    COSC Needed for Physician Office Orthopedic Coding

    Immediate, experienced COSC needed to perform orthopedic audits of office and surgical procedures as well as E&M visits for busy ortho practice. Must have current in depth knowledge of orthopedic surgical coding and compliance rules for billing. Knowledge of physical therapy and x-ray coding a...
  15. C

    Billing E/M Visit and Xray

    I need some help with documentation of some coding guidelines. I work for an orthopedic surgery practice and we are currently setting up our EMR to document E/M visits and have hit some road blocks. I have heard several different places that if you are billing for both the technical and...
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